Moral Distress In The Health Professions

This is the first book on the market or within academia dedicated solely to moral distress among health professionals. It aims to bring conceptual clarity about moral distress and distinguish it from related concepts. Explicit attention is given to the voices and experiences of health care professionals from multiple disciplines and many parts of the world. Contributors explain the evolution of the concept of moral distress, sources of moral distress including those that arise at the unit/team and organization/system level, and possible solutions to address moral distress at every level. A liberal use of case studies will make the phenomenon palpable to readers. This volume provides information not only for academia and educational initiatives, but also for practitioners and the research community, and will serve as a professional resource for courses in health professional schools, bioethics, and business, as well as in the hospital wards, intensive care units, long-term care facilities, hospice, and ambulatory practice sites in which moral distress originates.

Suffering is an unavoidable reality in health care. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, in part a reflection of the increasing complexity of health care, their roles within it, and the expanding range of available interventions. Moral suffering is the anguish that occurs when the burdens of treatment appear to outweigh the benefits; scarce human and material resources must be allocated; informed consent is incomplete or inadequate; or there are disagreements about goals of treatment among patients, families or clinicians. Each is a source of moral adversity that challenges clinicians' integrity: the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. If moral suffering is unrelieved it can lead to disengagement, burnout, and undermine the quality of clinical care. The most studied response to moral adversity is moral distress. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. It is vital to shift the focus to solutions and to expanded individual and system strategies that mitigate the detrimental effects of moral suffering. Moral resilience, the capacity of an individual to restore or sustain integrity in response to moral adversity, offers a path forward. It encompasses capacities aimed at developing self-regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum approach, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and source the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all.

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.

This book provides a bridge between the theory to practice gap in contemporary health care ethics. It explores the messiness of everyday ethical issues and validates the potential impacts on health care professionals as wounded healers who regularly experience close proximity to suffering and pain. This book speaks to why ethics matters on a personal level and how moral distress experiences can be leveraged instead of hidden. The book offers contributions to both scholarship and the profession. Nurses, physicians, social workers, allied health care professionals, as well as academics and students will benefit from this book.

"Moral injury is defined as the sort of harm that results when someone has perpetrated, failed to prevent, or witnessed acts that transgress deeply held moral beliefs. Social workers and other human services professionals are well versed in the ravages, symptoms, and treatment of the complicated forms of posttraumatic stress that accompany moral injury, and the issue has been gaining attention. The purpose of this book is to provide in-depth discussion of the concepts of moral injury, moral distress, and moral demoralization; common causes; the ways in which moral injury, moral distress, and moral demoralization are manifested; the causes of moral injury, moral distress, and moral demoralization; secondary trauma, including the ways in which moral injury, moral distress, and moral demoralization affect practitioners; ethical/moral dilemmas; prevention strategies; the role of advocacy and moral courage; and practitioner self-care and resilience. The book includes extensive case examples (clinical, administration, policy practice, advocacy) drawn from the author's experience in and consultation with practitioners employed in public welfare offices, mental health agencies (residential and nonresidential), child and family services programs (residential and nonresidential), substance use programs (residential and nonresidential), housing and homelessness programs, prisons, schools, hospitals, military settings, private/independent practice, immigration and refugee resettlement programs, nursing homes, HIV/AIDS programs, disabilities services programs, hospice programs, and parole/probation offices, among others"--

" This is the first research-based book to confront workplace issues facing nurses who have disabilities. It not only examines in depth their experiences, roadblocks to successful employment, and misperceptions surrounding them, but also provides viable solutions for creating positive attitudes towards them and a welcoming work environment that fosters hiring and retention. From the perspectives and actual voices of nurses with disabilities, nurse leaders, nurse administrators, and patients, the book identifies nurses with disabilities (including sensory, musculoskeletal, emotional, and mental health issues), discusses why they choose to leave nursing or hide their disabilities, and analyzes how their disabilities may influence career choices. "